Organization
SOUTHERN PHYSICAL AND AQUATIC THERAPY, P.A.
Active
Organization
SOUTHERN PHYSICAL AND AQUATIC THERAPY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WASHINGTON (OWNER)
(662) 509-0475
Entity
Organization
Contact information
Practice address
369 PEOPLES DRIVE, PONTOTOC, MS 38863
(662) 509-0475
Mailing address
3161 HIGHWAY 334, PONTOTOC, MS 38863-6160
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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